Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage

FAB RESEARCH COMMENT:

In this paper, a leading world expert in biochemistry and nutrition offers a comprehensive new theory to explain why and how deficiencies of vitamins, minerals and other essential micronutrients are likely to increase long-term risks for the many of the 'degenerative diseases' associated with aging.

As periods of micronnutrient scarciity have been common throughout human evolution, his proposal is that it makes sense for a 'triage' system to have evolved, whereby scarce nutrients are prioritised to support immediate survival needs, while those with longer-term implications (such as DNA repair, or other basic maintenance functions) have their priority downgraded.

'Diet and lifestyle' factors are well known to play a large part in the increasing rates of age-related 'systemic' or non-communicable diseases (NCD) such as cardiovascular disease, cancer, Alzheimer's disease and other neurological disorders.  

However, randomised controlled trial evidence to demonstrate definitive causal effects of nutrition and diet in the development of these kinds of conditions remains extremely limited.  Both practical and ethical considerations make such trials difficult enough to conduct even in healthy professional volunteers, let alone the general population, or vulnerable groups, for many reasons, including:

• the very long latency period of these kinds of diseases (now known to span not just years, but decades in some cases)
• the sheer number and complexity of the different nutrients and mechanisms involved - let alone their interactions with each other
• the impossibilty of achieving true 'placebo' groups for essential nutrients
• individual differences not only in baseline nutrient status, but their absoprtion and metabolism 

By definition, adequate supplies of all essential nutrients are of fundamental importance to human health - and yet for populations consuming modern, western-type diets, multiple micronutrient deficiences are common even in rich, developed countries like the US and UK.

The author summarises evidence for both 'theory and mechanisms' and 'association studies' that support his proposed 'triage' theory, explaining and highlighting:

• known biochemical mechanisms by which specific nutrient deficiencies have already been shown to affect various tissues, organs and systems implicated in the development of cardiovascular disease, cancer and other degenerative disorders.

• evidence from prospective epidemiological studies using both clinical and general population samples - which consistently show that nutritional deficiencies often predict an increased likelihood of age-related degenerative diseases many years in advance of their emergence.

In addition to flagging what kinds of research could be used to test the theory proposed, he also makes a compelling case for public health policy to do more to improve nutrition at the population level, including recommendations for multivitamin and mineral supplementation as a rational way to reduce current widespread nutrient deficiencies.

See also:

• Evidence-based decision making on micronutrients and chronic disease: long-term randomized controlled trials are not enough